Inspection on 13/12/05 for Victoria House

This inspection was carried out on 13th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Victoria House 07/08/08

Victoria House 08/08/07

Victoria House 15/06/06

Victoria House 14/06/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Victoria House 25 Victoria Avenue Brierfield Nelson Lancashire BB9 5RH Lead Inspector Mrs Pat White Unannounced Inspection 13th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Victoria House Address 25 Victoria Avenue Brierfield Nelson Lancashire BB9 5RH 01282 697535 01524 845667 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Delta Care Limited Ms Maxine Anne Quigley Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered to provide personal care for up to 15 service users who fall into the category of Older People (OP) 14th June 2005 Date of last inspection Brief Description of the Service: Victoria House is an older type detached two-storey property, in a residential area on the outskirts of Brierfield. The home is registered to provide accommodation and care for 15 older people over the age of 65 yrs of age. Accommodation consists of single and double bedrooms on the first floor, two lounges and a separate dining room on the ground floor. Two stair lifts join the two floors. Various aids and adaptations were available; including hand rails and grab rails. There were two bathrooms providing assisted bathing, including a shower. There were no en suite facilities, but commodes were provided in each bedroom and there were sufficient communal toilets. Delta Care Ltd purchased the home in February 2005 and Mr Baki of the company was the Responsible Individual. At the time of the inspection, due to the resignation of the registered manager, the deputy manager was “acting manager”. Victoria House received the Investors in People Award in 2002. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Summary of the Unannounced Inspection on the 13/12/05 This inspection was an unannounced inspection, the purpose of which was to assess important areas of life in the home that should be inspected over a 12 month period, check the progress of previous legal requirements and good practice recommendations, and check other matters in the home which came to the inspector’s notice. One complaint made directly to the home, regarding a member of staff, was also checked, and has been summarised in the relevant section of the main report. The inspection took 6 hours, 45 minutes and comprised of, talking to residents, a look around some of the premises, looking at resident’s care records and other documents, and discussion with the acting manager and the owner, Mr Baki. Seven residents were spoken with and others were observed in their routine daily activities. One relative was spoken with. Note The summary is particularly written for residents, and staff are asked to make sure some of the residents are able to read it or are made aware of it. The home should also ensure that the full report is widely available to all those who are interested. What the service does well: The home was successful in meeting the needs of the residents. There was a good atmosphere in the home and residents and staff appeared to get on well. There has also been consistent praise from residents and relatives for the environment, the food served and the care given by staff. At this inspection all residents spoken with praised every aspect of the home. Residents praised staff for their kindness and patience and comments such as “It’s a lovely home” and “I like living here because of the company” were made. The home provides pleasant, homely and comfortable accommodation with a high standard of décor and furnishings, which suits the residents’ tastes and needs. Residents complimented the environment, and comments such as “it is pleasant and comfortable” were made. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: The way in which residents’ needs, and the plans for meeting these needs, were recorded could be further improved. For example more details could be recorded on the care plans such as how the risk of falling, and the risk of using bedrails, can be reduced. Medication management and procedures must be further improved to ensure the safety and well being of the residents and number of legal requirements must be met. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 7 The way members of staff are recruited could be further improved, so that staff do not commence work until full police checks have been obtained to ensure that residents are protected from staff with an unsuitable record. All the records relating to staff and residents, as listed in the Care Homes Regulations, must be kept in the home so that there is written evidence that the home is following correct procedures. Some aspects of the health and safety of residents and staff must be improved. To protect residents from accidents, immediate action must be taken to repair broken sash windows so that residents are not at risk from windows that are propped open and also to make sure residents are not at risk from windows that open wide. Mr Baki must also make sure that the home’s water supply does not carry infectious micro - organisms and that fire drills are held at appropriate intervals. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 5 The home’s admission procedures, including pre admission assessments and prior visits by prospective residents and relatives to the home, helped to determine whether or not the home could meet people’s needs. EVIDENCE: The viewing of residents’ records showed that the previous manager had undertaken pre admission assessments with those residents recently admitted. The social work assessment had been obtained for one resident recently admitted under care management arrangements and the registered person had confirmed in writing to her that the home could meet her needs. The in house assessment documentation included all the matters listed in standard 3.3 All residents spoken with indicated that their needs were met. Residents stated that they were happy living in the home, that they were well cared for and that staff treated them well. A recently admitted resident stated that she had settled, and liked living in the home. Mr Baki had confirmed in writing that Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 10 her needs could be met in the home. One relative stated that she thought her mum was well looked after but that there didn’t always seem to be enough staff on duty (see standard 27). The inspection methods showed that residents and relatives were able to visit the home prior to admission and that the person carrying out the assessment visited people in their home environment to carry out the pre admission assessment. This assisted people to make a choice about whether or not they wanted to live at Victoria House. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The care planning process and documentation had improved, but would still benefit from the inclusion of all aspects of residents’ personal, health and social care needs to ensure these needs are met. The residents’ physical and psychological health was promoted and maintained, and improvements in medication management and systems, enhanced this. The residents’ rights to privacy and dignity were respected. EVIDENCE: All the residents had care plans prepared from an assessment (see standard 3) and the detail recorded on these plans had improved. The care plan documentation included all matters listed in standard 3.3, and there were comprehensive risk assessments on matters relating to mobility, moving and handling and the risk of falling. However these had not all been appropriately completed for all the residents whose records were viewed. When risks have been identified, including risk of falling and risks relating to nutrition, risk assessments must be undertaken. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 12 Care plans were being reviewed, but it is recommended that they be reviewed more frequently and at least on a monthly basis. The inspection methods used showed that residents’ physical and psychological health was promoted and maintained, and that residents had access to all necessary health care professionals. The intervention and advice of the appropriate district nurses were sought for pressure area care and continence promotion. However risk assessments must be carried out on whether or not bedrails should be used. Information about diet and food preferences was recorded on the care plans, and residents’ weights were regularly monitored and recorded. However comprehensive nutrition assessments were not undertaken. There had been substantial improvement in some aspects of medication management and some legal requirements made at the last inspection had been met. These include, the development of policies and procedures, all members of staff administering medication were undertaking training and the prescriptions were being checked by the home prior to dispensing. However more improvements must be made to ensure the safe administration of medication and a number of requirements have been made. The policies and procedures did not include the ordering of medication, drug errors, covert administration and non – prescribed medication. At the time of the inspection there were no records of medication leaving the home and there were unexplained gaps on some MAR sheets viewed. Written alterations to the MAR sheets were not always witnessed (double signed). The temperatures of the medication storage areas must be monitored regularly. There must be a recognised means of identification of residents and a staff signature list. Residents’ rights to dignity, respect and privacy were understood by staff, and upheld. This was confirmed by some of the residents spoken with. One resident said that the staff were “very good and kind” and treated her appropriately. Members of staff were observed treating residents with kindness and respect. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 Routines in the home were flexible enough to suit individual choices and preferences. Residents were encouraged to maintain contacts with relatives and friends and the wider community and visitors were made to feel welcome in the home at any time. EVIDENCE: Routines of daily living appeared flexible enough to suit individual residents’ expectations and preferences. Some of these preferences were recorded on the care plan. All residents spoken with stated that there were suitable activities, such as playing games and movement to music. Activities were advertised on the notice board. Church ministers of different denominations visited the home. Contacts with family, friends and the local community were encouraged. One visitor said, “staff are always friendly and welcoming”. Delta Care had a minibus with wheelchair access. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home had a complaints procedure that was understood by residents and visitors. Residents felt safe living in the home and this was supported by policies and procedures for the protection of residents from abuse. EVIDENCE: The home had a simple complaints procedure. A complaint regarding criminal activity of a member of staff had been made directly to the home (see standard 29). At the time of the inspection the records of this complaint were not in the home. However Mr Baki subsequently demonstrated that the complaint had been investigated and recorded satisfactorily (see standard 37). All residents spoken with stated that they had no complaints and several stated they would not hesitate to speak to a member of staff or Mr Baki if they were unhappy about any aspect of their care. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 15 The home had an adult protection policy that included a whistle blowing policy and stated step by procedures to be followed in the event of an allegation or suspicion of abuse. Staff would benefit from guidance on dealing with aggression from residents, and procedures should be developed, according to standard 18.6, which support the protection of residents’ money and valuables. There had been no recorded incidents, or allegations of abuse in recent years and residents stated that they felt safe living in the home. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 25 Although the standards in this section were not inspected in full, it was clear that the home provided a clean, comfortable and pleasant environment for the residents. However some aspects of the premises’ safety must be improved. EVIDENCE: In relation to the premises and the environment, only previous legal requirements were checked. The two requirements - to repair broken sash windows and ensure the water supply does not pose a threat to Legionella had not been met and Mr Baki must address this with priority (see standard 38). In addition it was noted that a lounge carpet had been replaced and there was a new fridge/freezer. It was also noted that the parts of the home viewed were clean and fresh with no unpleasant odours. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 29 The home had sufficient staff on duty to meet the needs of the residents and the home’s staff recruitment policies and procedures had improved to meet statutory requirements, and to help protect residents from unsuitable staff. The staff training programme was being developed according to the needs of the residents and staff. EVIDENCE: According to the residents spoken with, and observations made at the time of the inspection, the staffing levels appeared to be meeting the needs of the residents. However care hours had been recently reduced as the number of residents living in the home had fallen. One relative stated that she didn’t think there was always enough staff on duty, particularly to organise leisure activities for the residents. Mr Baki stated that due to the sudden resignation of the registered manager he would be spending a lot more time in the home and would keep staffing levels under review. There was a cook and cleaner working in the home and high standards of food served and cleanliness were being maintained. Staff appeared caring and kind to residents, and these were words frequently used by residents to describe the staff. Members of staff were observed giving appropriate assistance. The atmosphere in the home was convivial with an apparent good rapport between staff and residents. Residents spoken with praised the care and attitude of the staff and stated that they were well treated by staff. One member of staff spoken with stated that, despite the Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 18 home going through a difficult time due to the sudden departure of the manager, good standards of care to residents were being maintained. With regard to staff recruitment, key records were not kept in the home at the time of the inspection (see standard 37). Mr Baki subsequently demonstrated that the procedures for recruiting staff had improved since the previous inspection and that members of staff were not commencing work until POVA checks and two written references had been obtained. A complaint had been made directly to the home regarding criminal activities of a member of staff working in the home prior to the receipt of the CRB check. The outcome of the complaint investigation resulted in the member of staff being dismissed. It is strongly recommended that staff do not commence work until the full CRB checks have been obtained. With regard to staff training, only the previous recommendation was assessed. At the time of the inspection there were no records of staff induction kept in the home, but Mr Baki subsequently provided evidence that the home’s induction programme was in accordance with the “Skills for Care” guidance. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 37 & 38 There was no registered manager at the time of the inspection and staff and residents would benefit from stable management. All staff and residents’ records according to the Care Home’s Regulations should be available to demonstrate that the correct procedures are being followed in all areas of the running of the home. The health and safety of the residents and staff was promoted but further improvements need to be made. EVIDENCE: The registered manager suddenly resigned a few days prior to the inspection. At the time of the inspection the deputy manager was the “acting manager”. Mr Baki, was working in the home at the time of the inspection to ensure that the home was suitably managed and run, and to resolve the current management issues. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 20 Staff meetings and residents meetings were being held to assist their respective involvement in the running of the home. Mr Baki stated that to further this, a quality monitoring survey had been undertaken since the previous inspection involving residents, staff and relatives. The results of this survey were not available in the home at the time of the inspection. The records viewed were up to date and kept according to the regulations. However some were not on the premises at the time of the inspection and these have been identified in the relevant sections of the report. Since the previous inspection staff appraisals had been undertaken for the first time, and the registered person will continue to see staff on a one to one basis. Staff meetings were now being held regularly and the member of staff spoken with stated that Mr Baki was supportive and accessible. The health and safety matters in the home were not fully inspected at this inspection, but the progress on the previous requirements was monitored. These were found to be still outstanding from the previous inspection and must be addressed as a matter of urgency to ensure the safety. The matters of concern were: a broken sash window that was propped open with a wooden block, no evidence that the home’s water supply did not pose a threat of Legionella, outstanding maintenance checks on the gas boiler and the central heating system and no current guidance from the fire service regarding the frequency of fire drills. Following the inspection the registered person notified the CSCI that the broken sash window had been repaired through the fitting of a window restrictor, and that all sash windows will have window restrictors fitted by the end of January. Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X 2 x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x x 2 2 Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13(4) (b)(c) & 15 13(8)17 (1a) sch 3 13 (2) Requirement When risks have been identified, including risk of falling and in relation to nutrition, risk assessments must be completed. The use of bedrails must be subject to a risk assessment and kept under review. The medication policies and procedures must be developed to cover all areas of recording, storage, handling, administration and disposal of medication. These must include ordering medication, drug errors, covert administration and non – prescribed medication (Previous timescale of March 2005 not met) Accurate records must be kept of all medication received into and leaving the home and administered to residents. (Previous 2 timescales not met) Any changes in doses made by a medical practitioner must be clearly recorded and witnessed on the MAR sheets The temperature of the medication storage areas must DS0000063398.V272556.R01.S.doc Timescale for action 31/01/06 2. 3. OP8 OP9 31/01/06 31/01/06 4. OP9 13 (2) 31/01/06 5. OP9 13 (2) 31/01/06 6. OP9 13 (2) 31/01/06 Victoria House Version 5.0 Page 23 7. OP9 8. OP19 9. OP31 10. OP33 11. 12. OP37 OP38 13. OP38 14. OP38 be monitored regularly. There must be a recognised means of identification of residents for the administration of medication. 13 (4)(a) The registered person must & (c) ensure that broken sash windows are made safe and that the propping open of these windows ceases. The registered person must inform the CSCI of the action taken by the 19/12/05 of what action has been taken (Previous timescale of 14/07/05 not met) 9 The registered person must ensure that there is a suitably experienced, competent and qualified manager in post 24 (2) A report of the quality monitoring review and must be supplied to the Commission and this information must be made available to the residents and relatives. 19 sch 2 All the records specified in the 17 sch 3 4 Care Homes regulations must be kept in the home 13(3) & The registered person must (4a)&(c) ensure that the homes water supply does not pose a threat of the spread of Legionella. (Previous 2 timescale not met) 23 (4)(e) The fire service must be consulted on the frequency of fire drills and all staff must attend at appropriate intervals (Previous timescale of the 31/07/05 not met) 13 (4)(c) The homes gas appliances, boilers and central heating system must be serviced by the date agreed and a certificate obtained. A copy of this must be sent to the CSCI by 31/01/06 (Previous timescale of 31/07/05 not met) 13 (2) DS0000063398.V272556.R01.S.doc 31/07/05 19/12/05 17/02/06 31/01/06 13/12/05 28/02/06 31/01/06 31/01/06 Victoria House Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard OP7 OP8 OP9 OP18 OP19 OP29 OP36 Good Practice Recommendations The care plans should be reviewed more frequently, and at least on a monthly basis. It is recommended that comprehensive nutrition assessments are undertaken The registered person should ensure that homely remedies are not administered without the authorisation of the GP. Policies and procedures to support the safeguarding of residents money and valuables according to standard 18.6 should be developed. The registered person should undertake regular audits of the premises to ensure rapid identification of, and action on, parts of the premises which need repairs and renewals It is recommended that members of staff do not commence work until the full CRB checks have been obtained. It is recommended that staff receive formal one to one supervision according to standard 36 Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Victoria House DS0000063398.V272556.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!